This proposal builds upon our established Medical Monitoring Program for the WTC responders, seeking to create a long-term program for patient assessment, tracking, data collection, treatment and coordination to further elucidate, describe and treat the medical, social and psychological sequelae of this disaster. We seek also to improve access for care for LI responders by offering comprehensive services at local locations. Specifically, we will: SPECIFIC AIMS 1. To provide comprehensive health monitoring and treatment services of World Trade Center (WTC) - related conditions for WTC responders, including out-patient and, when needed, in-patient treatment, through the participation in a coordinated network of clinical facilities; 2. To identify, implement, evaluate, and revise as needed, appropriate protocols, procedures, and outcomes for treatment of WTC-related health conditions, using best available evidence from all relevant WTC responder clinical and research programs; 3. To characterize the evolution of WTC-related health conditions, including the detection of new health conditions, among WTC responders; 4. To assist WTC responders and their families to secure health benefits, workers' compensation and other appropriate services; 5. To engage in bi-directional communication of program results, i.e., a) to provide individual health and other monitoring and treatment program data to the WTC Data Coordination Center for aggregation and analysis, and b) to disseminate program results to WTC responders, other relevant parties, and the general public. [unreadable] [unreadable] [unreadable] [unreadable]